脉冲治疗联合SET对神经根型颈椎病患者颈椎生物力学及颈部肌疲劳度的影响

Effect of pulse therapy combined with SET on cervical biomechanics and cervical muscle fatigue in patients with cervical spondylotic radiculopathy

目的探讨脉冲治疗联合悬吊训练技术(sling exercise therapy,SET)治疗神经根型颈椎病的效果及其对颈椎生物力学及颈部肌疲劳度的影响。方法选择神经根型颈椎病患者162例,按随机数字表法将患者分为对照组和观察组,每组81例。对照组采用SET治疗4周,观察组采用脉冲治疗联合SET治疗4周。比较2组治疗前后颈椎功能、疼痛程度、颈椎生物力学、颈部肌疲劳度和并发症发生情况。结果治疗后,2组日本骨科协会颈髓功能(Japanese orthopedic association,JOA)评分、颈椎前屈角度、后伸角度、左侧屈角度、右侧屈角度、左侧旋角度、右侧旋角度、颈部后伸肌群肌电积分值(integrated electromyography,IEMG)、平均功率频率(mean power frequency,MPF)、中位频率(median frequency,MF)均高于治疗前(P<0.05),颈椎功能残障指数(neck disability index,NDI)、视觉模拟评分法(visual analogue scale,VAS)评分较低于治疗前(P<0.05)。观察组JOA评分、颈椎前屈角度、后伸角度、左侧屈角度、右侧屈角度、左侧旋角度、右侧旋角度、颈部后伸肌群IEMG、MPF、MF高于对照组(P<0.05),NDI指数、VAS评分低于对照组(P<0.05)。2组并发症发生率差异无统计学意义(P>0.05)。结论脉冲治疗联合SET可有效提高神经根型颈椎病患者颈椎生物力学,降低肌疲劳度,改善颈椎功能。

Objective To investigate the effect of pulse therapy combined with sling exercise therapy(SET)on cervical spondylotic radiculopathy(CSR)and its impact on cervical biomechanics and cervical muscle fatigue.Methods A total of 162 patients with CSR were selected and divided into the control group(n=81)and the observation group(n=81)according to random number table method.The control group was treated with SET for 4 weeks,while the observation group was treated with pulse therapy combined with SET for 4 weeks.Cervical function,pain,cervical biomechanics,cervical muscle fatigue and complications were compared between two groups before and after treatment.Results After treatment,Japanese Orthopedic Association(JOA)score,cervical flexion angle,cervical extension angle,left flexion angle,right flexion angle,left rotation angle,right rotation angle,integrated electromyography(IEMG)value of cervical extensor muscle group,mean power frequency(MPF)and median frequency(MF)in two groups were higher than those before treatment(P<0.05),while neck disability index(NDI)and visual analogue scale(VAS)score were higher than those before treatment(P<0.05).The JOA score,cervical flexion angle,cervical extension angle,left flexion angle,right flexion angle,left rotation angle,right rotation angle,IEMG of cervical posterior extensor muscle group,MPF and MF in the observation group were higher than those in the control group(P<0.05),while the NDI index and VAS score were lower than those in the control group(P<0.05).There was no significant difference in the incidence of complications between two groups(P>0.05).Conclusion Pulse therapy combined with SET can effectively improve cervical biomechanics,reduce muscle fatigue and improve cervical function in patients with CSR.